Application & Request Forms

The following forms are commonly used for research purposes.

Research Billing Forms: The outpatient/Inpatient registration forms must be utilized by the research staff to identify the “research” service (fund #) that is being ordered for the patient in study. The completed forms must be submitted to patient registration along with prescription & email a copy to both clinicaltrialsfinance@nshs.edu and crs@nshs.edu.